Sam SmithSan Antonio is one of the fastest-growing metro areas in the United States, offering a unique blend of historic military presence, world-class medical institutions, and a rising technology ecosystem. Unlike many cities where tech dominates top-earning roles, San Antonio’s highest-paying careers are primarily concentrated in advanced medicine, healthcare leadership, military command positions, and corporate executives tied to major employers like USAA and Toyota. With a relatively low cost of living and strong job stability across sectors such as bioscience, defense, finance, and advanced cybersecurity, the region provides exceptional earning potential and long-term career growth for highly skilled professionals.
Highest-paying Jobs in San Antonio, TX -The Money Rank
1. Health System CEO / President
Health system CEOs in San Antonio oversee major hospital networks, manage thousands of employees, and direct large budgets for patient care, research, and expansion. With institutions like UT Health San Antonio and Methodist Healthcare, these leaders guide strategy, quality, and partnerships across the medical community. Their role involves crisis management, technology adoption, physician network leadership, and compliance with healthcare regulations. Deep executive experience, strong financial oversight skills, and a Master’s in Health Administration or MBA are typical requirements.
2. Chief Executive Officer (Corporate)
Corporate CEOs at top San Antonio companies—such as USAA, Frost Bank, and iHeartMedia—guide organizational growth, financial performance, product strategy, and long-term planning. They oversee senior executive teams, drive innovation, and ensure stakeholder, shareholder, and regulatory responsibilities are met. Their days involve leadership meetings, financial reviews, strategic decision-making, and public representation. Most have 15+ years of progressive corporate leadership, a strong industry background, and advanced business degrees, particularly MBAs.
3. Surgeon (Specialties: Orthopedic, Neurosurgery, Cardiology)
Surgeons in high-demand specialties perform complex operations, often life-saving procedures, requiring precision and years of medical training. In San Antonio’s South Texas Medical Center, surgeons work in high-tech operating environments, lead surgical teams, consult patients, and coordinate care with specialists. Their workload includes trauma surgeries, elective procedures, and emergency operations. Licensing, residency, and fellowship completion are required, along with strong decision-making skills, manual expertise, and stamina. Specialized surgeons earn among the region’s highest compensation.
4. Hospital Chief Medical Officer (CMO)
Chief Medical Officers supervise medical staff, oversee patient-care quality, develop clinical standards, and ensure regulatory compliance across large health systems. They bridge clinical practice and executive leadership, often managing budgets, research initiatives, and physician recruitment. CMOs coordinate with department heads to implement new care models, technology platforms, and safety programs. Most hold MD or DO credentials with extensive clinical background, plus training in healthcare administration or executive leadership. Strong communication and analytical skills are essential.
5. Chief Financial Officer (CFO)
CFOs in San Antonio lead financial planning, cash-flow management, accounting systems, and investment decisions for major companies and hospital systems. They work closely with CEOs and boards, prepare financial forecasts, manage risk, and oversee audit and compliance needs. Their role often includes capital-raising strategies, cost-efficiency planning, and corporate expansion support. CFOs commonly hold MBAs, CPA certifications, and executive-level experience. Their responsibilities are critical to maintaining financial strength and long-term business growth.
6. Anesthesiologist
Anesthesiologists administer anesthesia during surgery, monitor vital signs, and manage patient recovery. In San Antonio’s trauma-center-rich medical district, they support high volumes of surgical and emergency procedures. They evaluate patients before surgery, tailor anesthesia plans, and respond to complications. Training includes medical school, residency, and certification. Their work requires precision, calm under pressure, and deep knowledge of internal medicine, pharmacology, and critical care. High demand and long hours contribute to significant compensation.
7. Psychiatrist
Psychiatrists diagnose and treat mental health disorders through therapy, medication, and intervention plans. With rising behavioral-health demand across Texas and a shortage of providers, San Antonio psychiatrists serve hospitals, clinics, and military healthcare facilities. They evaluate patients, monitor treatment response, and collaborate with psychologists and social workers. Many treat PTSD and trauma-related conditions due to the region’s military population. Training involves medical school, residency, and board certification. Work can be emotionally intensive but highly impactful.
8. Orthodontist / Oral Surgeon
Dental specialists like orthodontists and oral surgeons treat advanced oral health issues, perform corrective surgeries, and manage facial trauma cases. In San Antonio, they operate private practices or work in large dental groups. Their responsibilities include patient consultations, surgical planning, anesthesia use, and post-operative care. Training includes dental school plus specialty residency. Strong interpersonal skills, hand-eye coordination, and business management abilities (for practice owners) are essential. High demand drives competitive earnings.
9. Nurse Anesthetist (CRNA)
CRNAs administer anesthesia under physician supervision and manage patients during surgical procedures. In San Antonio’s busy hospital systems, they assist with major surgeries, obstetric care, and outpatient procedures. Their work includes pre-operative preparation, monitoring, and emergency support. CRNAs complete advanced graduate programs, maintain licensure, and operate in high-pressure environments requiring independent judgment. They are among the highest-paid nursing professionals due to specialized skills, intensive responsibilities, and demand in surgical and military medicine settings.
10. Corporate Vice President (Operations / Finance / Engineering)
Corporate Vice Presidents oversee key departments, manage large teams, and execute business strategies at major employers like USAA, H-E-B corporate, and Toyota. They translate executive vision into daily operations, manage budgets, evaluate performance metrics, and lead cross-department initiatives. Many specialize in finance, supply chain, or engineering. A strong track record in leadership, project execution, and industry expertise is essential. VPs typically hold advanced degrees and 10+ years of senior-level experience.
11. Radiologist
Radiologists interpret medical images to diagnose disease, trauma, and internal conditions, collaborating closely with physicians and surgeons. In San Antonio’s large healthcare centers, they analyze MRI, CT, and ultrasound reports, perform image-guided procedures, and consult on treatment planning. Training includes medical school, residency, and fellowship. Their work requires deep diagnostic skills, attention to detail, and proficiency with imaging technology. Long shifts and high responsibility correspond to strong earnings potential.
12. Senior Military Officer (Colonel / Navy Captain)
Senior military officers stationed at Joint Base San Antonio oversee major units, coordinate missions, manage training operations, and direct personnel across medical, intelligence, and aviation units. Their compensation includes base pay, housing allowances, pension benefits, and special duty pay. Most have decades of service, advanced military education, and extensive operational leadership experience. These roles demand discipline, strategic planning, and high-stakes decision-making—often supporting national defense and regional medical commands.
13. Physician – Family / Internal Medicine (Senior Level)
Senior primary-care physicians manage long-term patient care, diagnose and treat common medical conditions, and coordinate specialist referrals. In San Antonio’s growing population and military community, they support preventive care and chronic-disease management. Experienced physicians often lead clinic practices, mentor younger providers, and develop advanced care protocols. Their training includes medical school, residency, board certification, and continuing education. High demand, patient relationships, and administrative duties make this a rewarding and stable career path.
14. Dentist
Dentists diagnose and treat oral-health conditions, perform restorative procedures, and guide patient hygiene and preventive care. In San Antonio, dentists serve family clinics, advanced dental practices, and military dental facilities. Work includes exams, fillings, crowns, extractions, and sometimes sedation dentistry. Dentists complete dental school and licensure, often continuing with specialty training or business management for private practice. Strong manual skills, communication, and patient-care focus support success in this high-earning profession.
15. Engineering Manager (Mechanical / Electrical / Manufacturing)
Engineering Managers at companies like Toyota and aerospace contractors oversee engineering teams, manage production systems, and support product development and quality assurance. They coordinate design reviews, testing, project scheduling, and compliance. Most hold engineering degrees, Professional Engineer licensure preferred, plus 8+ years of experience. They need leadership, problem-solving, and strong technical knowledge. Their work ensures operational efficiency and innovation in manufacturing, automotive systems, and advanced industrial equipment.
16. Pharmacist
Pharmacists dispense medications, counsel patients, manage drug-interaction risks, and support safe medication use. San Antonio pharmacists work in hospitals, outpatient clinics, and retail settings. Many collaborate with physicians on chronic-care management and specialty therapies. Training includes a Doctor of Pharmacy degree, state licensure, and clinical knowledge. Detail-orientation, accuracy, and strong communication skills are essential. The role carries high responsibility for patient safety and remains well-compensated despite industry shifts.
17. Actuary (Fellow Level – USAA)
Fellow-level actuaries in major financial institutions like USAA analyze risk, design insurance products, and support investment strategy. Their work involves advanced statistical modeling, regulatory compliance, and long-term economic forecasting. They advise executives on pricing, reserves, and capital management. Becoming a Fellow requires rigorous exams, professional certification, and strong mathematical and analytical skills. Actuaries influence major financial decisions and enjoy stable, high-income careers in San Antonio’s insurance and finance sector.
18. Cybersecurity Manager / Architect
Cybersecurity leaders protect critical networks, oversee security architecture, respond to threats, and manage security-operations teams. With San Antonio’s strong defense and cyber-intelligence sector, they support military systems, tech hubs, and corporate networks. Certifications like CISSP and advanced degrees are common. Their work involves incident response, risk management, compliance programs, and emerging cyber-threat monitoring. Strong technical knowledge and leadership skills are essential in this mission-critical field.
19. Senior Software Engineer / Cloud Architect
Senior software engineers in San Antonio build and optimize systems for finance, healthcare, defense, and logistics companies. They lead development teams, design back-end systems, architect cloud platforms, and integrate cybersecurity standards. Most hold degrees in computer science or engineering and have extensive experience with modern programming languages and cloud technologies. Their role requires complex problem-solving, system-design knowledge, and collaboration across engineering and business units.
20. Aerospace Engineer (Senior Level)
Aerospace engineers connected to military aviation and defense contractors design and test aircraft systems, support flight-readiness programs, and ensure compliance with advanced safety standards. Their work spans propulsion, avionics, and aerostructures. Many collaborate with Joint Base San Antonio and private aerospace firms. A degree in aerospace engineering, technical specialization, and security clearance may be required. Strong analytical ability, engineering precision, and defense-industry knowledge drive high earning potential.
Top 100 Highest-Paying Jobs in San Antonio, TX
| Rank | Job Title | Typical Salary (San Antonio) |
|---|---|---|
| 1 | Hospital System CEO / President | $300,000 – $700,000+ |
| 2 | Chief Executive Officer (Private Sector) | $250,000 – $600,000+ |
| 3 | Chief Medical Officer | $300,000 – $550,000 |
| 4 | Orthopedic Surgeon | $400,000 – $600,000+ |
| 5 | Cardiothoracic Surgeon | $400,000 – $550,000+ |
| 6 | Neurosurgeon | $350,000 – $550,000 |
| 7 | Anesthesiologist | $350,000 – $500,000 |
| 8 | Radiologist | $350,000 – $475,000 |
| 9 | Corporate CFO | $250,000 – $450,000+ |
| 10 | Senior Military Officer (O-7 & above) | $200,000 – $350,000+ (incl. benefits) |
| 11 | Psychiatrist | $250,000 – $350,000 |
| 12 | Senior VP (Healthcare / Finance) | $200,000 – $330,000 |
| 13 | Gastroenterologist | $300,000 – $425,000 |
| 14 | Cardiologist | $300,000 – $425,000 |
| 15 | Emergency Medicine Physician | $300,000 – $400,000 |
| 16 | Dermatologist | $300,000 – $450,000 |
| 17 | Chief Information Security Officer (CISO) | $200,000 – $330,000 |
| 18 | CRNA (Nurse Anesthetist) | $180,000 – $230,000+ |
| 19 | General Surgeon | $275,000 – $400,000 |
| 20 | Ophthalmologist | $260,000 – $400,000 |
| 21 | VP of Operations / Engineering | $160,000 – $300,000 |
| 22 | Attorney / Senior Counsel | $160,000 – $260,000 |
| 23 | Senior Military Officer (O-6) | $150,000 – $230,000 (incl. allowances) |
| 24 | Senior Software Architect | $140,000 – $200,000 |
| 25 | Senior Actuary (USAA) | $140,000 – $200,000+ |
| 26 | Finance Director / Controller | $130,000 – $185,000 |
| 27 | Cybersecurity Manager / Architect | $130,000 – $180,000+ |
| 28 | Senior Program Manager (Defense) | $130,000 – $185,000 |
| 29 | Electrical Engineering Manager | $130,000 – $165,000 |
| 30 | Mechanical Engineering Manager | $130,000 – $165,000 |
| 31 | VP Supply Chain / Manufacturing (Toyota) | $140,000 – $240,000 |
| 32 | Orthodontist | $250,000 – $350,000 |
| 33 | Dentist / Oral Surgeon | $200,000 – $350,000 |
| 34 | Corporate Medical Director | $240,000 – $350,000 |
| 35 | Aviation Medical Examiner | $200,000 – $350,000 |
| 36 | Enterprise Sales Director | $120,000 – $250,000+ (commission) |
| 37 | Senior Intelligence Analyst | $110,000 – $170,000 |
| 38 | Senior Data Scientist | $130,000 – $180,000 |
| 39 | Senior Software Engineer | $120,000 – $165,000 |
| 40 | IT Director | $120,000 – $165,000 |
| 41 | Enterprise Architect | $120,000 – $175,000 |
| 42 | Physician Assistant (Surgical Specialty) | $120,000 – $160,000 |
| 43 | Nurse Practitioner (Specialty) | $115,000 – $150,000 |
| 44 | Pharmacist | $120,000 – $155,000 |
| 45 | Judge / Magistrate | $115,000 – $165,000 |
| 46 | University Dean | $120,000 – $185,000 |
| 47 | Veterinarian (Owner) | $100,000 – $200,000+ |
| 48 | Cyber Operations Specialist (DoD) | $110,000 – $160,000 |
| 49 | Aerospace Engineer (Senior) | $105,000 – $150,000 |
| 50 | Petroleum Engineer (Eagle Ford) | $120,000 – $180,000 |
| 51 | Construction Project Executive | $115,000 – $170,000 |
| 52 | Real Estate Development Exec | $120,000 – $200,000 |
| 53 | Military Cyber Defense Officer | $100,000 – $160,000 (incl. benefits) |
| 54 | Intelligence Program Lead | $100,000 – $150,000 |
| 55 | Industrial Engineering Manager (Toyota) | $110,000 – $155,000 |
| 56 | Bioinformatics Scientist | $100,000 – $145,000 |
| 57 | Marketing Director | $110,000 – $160,000 |
| 58 | Physical Therapist (Owner) | $95,000 – $175,000 |
| 59 | Occupational Therapist (Senior) | $95,000 – $135,000 |
| 60 | Biomedical Engineer | $95,000 – $135,000 |
| 61 | Financial Advisor (Top) | $90,000 – $200,000+ |
| 62 | Air Traffic Controller | $95,000 – $150,000 |
| 63 | Police Captain | $95,000 – $135,000 |
| 64 | Fire Battalion Chief | $90,000 – $130,000 |
| 65 | Hospital Operations Manager | $100,000 – $160,000 |
| 66 | Risk Manager (USAA / Insurance) | $95,000 – $150,000 |
| 67 | Senior Accountant / CPA | $85,000 – $120,000 |
| 68 | UX Designer (Senior) | $95,000 – $135,000 |
| 69 | Sales Manager | $85,000 – $150,000 |
| 70 | Supply Chain Manager | $95,000 – $145,000 |
| 71 | Logistics Program Manager | $95,000 – $135,000 |
| 72 | HR Director | $95,000 – $150,000 |
| 73 | University Professor (Tenured) | $90,000 – $145,000 |
| 74 | Airline Pilot | $90,000 – $200,000 |
| 75 | Real Estate Broker | $60,000 – $200,000+ |
| 76 | Senior Paralegal | $70,000 – $105,000 |
| 77 | Project Manager (Corporate) | $85,000 – $135,000 |
| 78 | Facilities Director | $90,000 – $140,000 |
| 79 | Information Security Analyst | $90,000 – $135,000 |
| 80 | Business Intelligence Analyst | $85,000 – $125,000 |
| 81 | Government Program Analyst | $85,000 – $125,000 |
| 82 | Hospital HR Manager | $85,000 – $130,000 |
| 83 | Laboratory Manager | $80,000 – $120,000 |
| 84 | Dental Hygienist | $80,000 – $110,000 |
| 85 | Radiation Therapist | $85,000 – $120,000 |
| 86 | Clinical Lab Scientist | $75,000 – $110,000 |
| 87 | Registered Nurse (Experienced) | $75,000 – $115,000 |
| 88 | Construction Superintendent | $85,000 – $135,000 |
| 89 | Police Sergeant | $75,000 – $105,000 |
| 90 | Fire Captain | $80,000 – $115,000 |
| 91 | Federal Border / TSA Officer (Senior) | $75,000 – $110,000 |
| 92 | HVAC Contractor | $70,000 – $150,000 |
| 93 | Electrician | $60,000 – $95,000 |
| 94 | Plumber | $60,000 – $95,000 |
| 95 | Diesel Mechanic | $55,000 – $90,000 |
| 96 | Logistics Coordinator | $60,000 – $90,000 |
| 97 | Real Estate Agent | $45,000 – $150,000 |
| 98 | Chef (Large Resort) | $70,000 – $120,000 |
| 99 | Hotel General Manager | $65,000 – $120,000 |
| 100 | Senior Admin / Executive Assistant | $60,000 – $95,000 |
Closing
San Antonio’s job market is both robust and evolving, offering high-income opportunities across healthcare, military leadership, corporate management, and emerging tech fields. For professionals seeking strong compensation paired with lower living costs, the city stands out as one of the most attractive destinations in Texas. As investment continues across the South Texas Medical Center, Port San Antonio’s tech innovation hub, and the defense corridor, salary potential and career advancement opportunities are poised to grow. Whether you are an executive, physician, engineer, or cybersecurity specialist, San Antonio offers a strong balance of income, lifestyle, and long-term economic stability.